Evan and Noah

12 days to go . . .

But who's counting???;)  Just a quick update on the twins.  Last week we had a little scare and actually thought the twins might be on their way.  My parents had their bags packed and it even looked like the twins and I would share a birthday on Friday.  The week prior my ultrasound appeared that both placentas were looking a little low on amniotic fluid.  (I have a history of this from my first pregnancy 8 years ago, so it's certainly something to watch.  My son had to be taken at 37 weeks as his fluid level became inadequate.)  Then, last Thursday my doctor did a more detailed ultrasound himself to decide what we should do.  We were all prepared for him to say that the babies needed to come out, as had happened with my son, but he felt like there was adequate fluid to let the twins grow two more weeks.  My doctor has delivered babies for 30 years, even has his own set of twins, so I fully trust his judgement.  The babies also passed their fetal non-stress test with flying colors that day.  While, I'm back on Tuesday for another check, the c-section has been scheduled for January 25th!  Both babies are breeched and have been the entire pregnancy, so this makes the decision pretty easy.  I have had very few contractions and zero cervical changes, so it looks like we will make it to the 25th.  At that point, I will be 37 weeks and 2 days, which for twins is considered full term.  We are pretty certain both babies are over 5 pounds now and will hopefully each put on another pound in the next 12 days.  Just to keep each placenta well perfused for ultimate blood flow to the growing babies, I have been put on baby aspirin (helps open capillaries), increased fluids (at least 2 liters of water/day), a daily tub bath with the water above my belly (buoyant babies also help with circulation), and 6 hours a day laying on my left side (this has been the hardest thing for me to get in).  One thing I've noticed with twins is there is no "nesting" energy spurt at the end.  I have zero energy!  Breathing and walking are not my friends right now!  While there is an end in sight to all of my aches and pains, my body (knees and hips especially) is done!  My list of things to do is long, but most days I have to accept defeat and know that I still have 12 days to work on things even if it's just one check off my list per day.  My mister has been busy doing a lot that I can't do, so that has helped a ton!  While I probably won't have my house as perfect as I want, I'm pretty sure the twins won't ask why I didn't get to the baseboards.;)    

5 months of survival and now 5 weeks to go!

My neglect of this blog the last five months is definitely a reflection of how sick I have been during this pregnancy!  I've tried not to complain too much because being miserably pregnant was our goal.;)  The first trimester was rough as I was still having daily Lovenox injections, steroids, hormones, baby aspirin, folgard, and prescription multivitamins.  The extra chemicals in my body added to my sickness, but also helped us maintain the pregnancy.  Not a day went by that I didn't remind myself of that.  The second trimester was the worst for nausea and vomiting, but getting off the blood thinners, steroids, and extra hormones certainly was nice.  Now at almost 32 weeks and into my last trimester, I'm so excited there is light at the end of the tunnel.  While I'm feeling better in some ways (no more vomiting), other discomforts have begun (aches, pains, heartburn, etc.).  I have already put on 50 pounds!  My nausea is the kind that needs to be fed.;)  The babies, which are BOYS, have been developmentally perfect so far.  At this point I have very frequent doctor visits (ultrasounds, stress tests, etc.) and the goal is to let them cook as long as they can.  

I'm kicking myself for not posting the day we found out their genders.  I found out at 14 weeks back on August 16th.  I didn't think they'd be able to tell and had brought my son and daughter with me thinking it would be a quick, uneventful appointment.  My mister was at work!  When the u/s tech asked if I wanted to know genders, I said "of course!"  She told us Baby B first . . . a boy!  My big kids were thrilled!  Then, she took a little longer determining Baby A, but announced he was also a boy!  I was shocked, but my eyes went straight to my 5 year old daughter . . . she was beaming!  Phew!  My son was of course thrilled and we immediately called my husband who was also thrilled.  For some reason, a boy/boy combo hadn't crossed my mind!  I figured they'd probably be boy/girl or girl/girl.  Once I absorbed this combo, I was also very excited!  I don't do well with girl drama and how seriously cute are two boys going through life together!;)

Anyways, I hate that I haven't been better at documenting this miracle pregnancy for our family!  On the flip side, I'm so grateful that we have survived this pregnancy and will finally be welcoming home our little fellas next month.  My big kids have been troopers and learned to be a little more independent when I couldn't get out of bed or off the couch.  My husband has also been very patient with me and had to pick up a lot of the workload at home while continuing to run his business.  After all that we have been through the last several years, I feel like bringing these babies home will be like making it to the top of a very tall mountain!;)  I cannot wait to nurse babies all day and night and maybe get a shower in the late afternoons.  I cannot wait to feel their two little heads in my neck and to see if they look alike.  I cannot wait to see my big kids attend to their every sound and movement.  My son already grabs my belly and says, "don't worry, we're going to get you out of there!"  I know they'll be good helpers.  I cannot wait to be recovered from my c-section of my two little breechlings.;)  For now, I still feel like a lot needs to happen in the coming weeks to get ready.  While the road to the point has been long, the end of this pregnancy has come quickly!  I do not want these boys spending one second in the NICU.  So grow babies, grow!

They've certainly come a long way from being our only two little embryos in a petri dish in a lab!!!  Here are some of their latest photos in 3D back at week 28:

Baby A

Baby B

We're seeing double . . .

Meet Baby A and Baby B, it's twins!!!

While the shock is still settling in, we are so thrilled that both embryos implanted and are doing great!  Our first ultrasound this morning had us all on pins and needles.  My mister said he could see my heart pounding though my shirt as we waited for my doctor to come in.  We were so nervous that something was going to be wrong.  The babies actually look perfect and were well synchronized with their heart rates and size.  Synchronization is a very good thing for twins especially this early on.  I'm about 6 1/2 weeks along, so we actually are only telling family and my select blog readers for now.;)  We have another ultrasound in 3 weeks and at that point I plan to shout it from the rooftops!  This explains why I'm so sick and starving . . . I'm eating for three!;)  While the due date is now around Valentine's Day, it sounds like these two will likely make their debut in January 2013.  That actually feels really close, and I feel like I have a lot to do between now and then!  For now though, I'm just going to get another snack and have a nap.;)

Update

My medications remain unchanged and I'm doing acupuncture once a week for pregnancy support now.  We are anxiously anticipating our first ultrasound on Monday!  This has been the longest week ever!;)  In a few weeks I will begin to wean off my steroids and hormones, which will be so nice!  My days still have to be planned around my medications being administered on time.  Pregnancy after IVF is definitely nothing like a natural pregnancy.  As my doctor said, they don't want to "rock the boat" once we get to this point so the first trimester includes a continuation of several of the IVF medications.  My morning blood thinner injection is making me so tired!  My mister does it before he leaves for work, and I'm usually dead to the world when he leaves.  I'm also feeling yucky in the mornings, so most mornings I try to go back to bed.  It looks like I will not get to wean off the blood thinner any time soon, but I'm hoping I can start giving it to myself and gradually make the time later.  Sleeping in will help a lot too as my morning sickness gets worse.  I still can't believe I'm pregnant and even took another pregnancy test on Monday just for reassurance.  Still positive!;)  Hopefully, Monday will come quickly and we can finally officially celebrate and start to relax.  

It's official . . . we're pregnant!

So today I went in to have my second beta hcg drawn.  It's a big deal, because increasing hcg indicates a healthy pregnancy.  While we were excited to have a positive test three days ago, we really needed to see an increase today.  Our last IVF cycle this is when my hcg dropped and things got ugly.  Today's results were 810, which is triple from our first test!  I spoke briefly with the embryologist while I was there and he said that 9 out 10 patients with my hcg levels this early on are carrying twins.  That would mean that both of our embryos implanted!  I got a little lightheaded when he said that, because I know that twins are high risk pregnancies and that our our lives would be drastically changed.  For now, our focus is getting to the ultrasound in two and a half weeks, which is the only way to determine how many embryos there are.  We would be thrilled with one and even more excited for two!  After so many years, it's still pretty surreal to actually be pregnant.  Neither my mister or myself have quite wrapped our minds around it yet, so hopefully the ultrasound will also help things sink in a little.  I'm between 4 and 5 weeks and the baby would be due the beginning of February or babies around the end of January.  Here's hoping the next few weeks and months go by quickly!  

First Beta HCG Results

Today was a big day!  We received my first beta hcg results.  I was up bright and early, and I'm pretty sure I was the first one at the lab.  Less than three hours later, my doctor called me herself to tell me that my beta was 269 . . . positive!  This is a little high for this early on, but there is no way to know if it is twins until my ultrasound in 2 1/2 weeks.  This is a huge milestone for us, but with our track record we are still not fully celebrating yet.  We will recheck my beta on Saturday to make sure that it is rapidly increasing, indicating a strong pregnancy.  Then, we need to make it to our first ultrasound to make sure our little embryo(s) are doing okay.  We choose not to do any genetic screening of the embryos this time, but are feeling good since they looked so great on day 5 (the blastocyst stage).  We are trying not to dwell on the past, but after three losses it's hard not to worry.  For now, we are thrilled beyond belief.  I keep thinking how glad I'm that we never gave up during this roller coaster process that has been going on for years!  I think after so many years of disappointment, we can't even wrap our minds around being pregnant!  There will be a 6 year gap between my daughter and this baby, so we are more than ready to enter the baby world again!

Another Day Out

I had an acupuncture appointment today and was told that I was doing "too much" and had to have an extended treatment. Then, I was sent back home to bed. I still haven't even left my house other than for lab work but apparently I shouldn't be going up and down my stairs so much. After being down for 5 days I need to take 5 days to more gradually get back to normal. Hopefully, my new normal will include morning sickness and I'm certain I'll run to the toilet with a smile on my face after all of this to get to that point!

First Day Out

Today was the first day I left my nest since the embryos were transferred. While I would have rather gone to church, I had an appointment at the IVF clinic for blood work. It was just to make sure all of my pregnancy support hormones were at appropriate levels and they were. The clinic reminds me a little of Walmart because they are always open! It was weird to pull up early on a Sunday and their parking lot was full. No long lines though, they have that part figured out. When it comes to IVF there are no "business hours."

Still keeping the bed warm!

My mom left today. Sad for me, good for her, I'm sure she needed a break! My mister is off the next four days so he will resume her duties. Let's just say the house might not sparkle and the food won't be like grandma's but the kids will still have fun and no one will go hungry. I have had a few friends ask me, so what now? After this weekend, I will gradually increase to light-normal activity. I still need to keep my heart rate below 140 to insure adequate uterine blood flow, no heavy lifting, no caffeine, etc. I'm still being followed by my doctor very closely with frequent lab work. Because I've lost my last three pregnancies, I'm on a slew of pregnancy "support" medicines. My doctor isn't taking any chances! I start each day with a Lovenox (blood thinner) injection as well as a baby aspirin at night to prevent placental micro-clots. I take steroids morning and night as well as mega-vitamins three times a day. My hormone support includes progesterone three times a day and estrogen in the mornings. I have 8 med alarms on my iPhone and there is no way I could keep track of things otherwise. If I'm pregnant (I mean after I find out that I'm pregnant), some of the meds will continue the entire pregnancy and some I will gradually be weaned off after the first trimester. I will also "graduate" to a regular ob/gyn after the first trimester. I can't wait for that thumbs up!

Still memorizing the pattern on the ceiling...

I think my daughter likes to come in and poke me every now and then just to make sure I'm still alive. My son came in today and said it would be weird if I stayed like this forever. They're not used to seeing me down. At least they're not kicking me;). Today I watched a movie to pass some time, finished a book, and tried learning to crochet. I thought I'd be pumping out a new crocheted scarf each day in bed, but I got frustrated and will need to keep practicing. I'm trying to stay positive so the crochet needle got put away. The scarf production will have to wait.

Bed rest isn't as great as it sounds!

Alright, so I'm not going to lie, the first 12 hours or so of bed rest are pretty nice! Laying in freshly washed sheets, my mom bringing in amazing food, complete silence because my kids are quickly ushered out if they get too loud or wiggly, and new jammies are all pretty awesome! Then after the first 12 hours pass, my back and bum get sore, I have a rat's nest on the back of my head, my entire mattress seems to disagree with my body, there's nothing left to watch or read, and my mind becomes obsessed with wanting to know if/when the embryos will implant. I haven't taken even one nap to pass the time because the high levels of hormones I'm on make it hard to even close my eyes. Time is pretty much standing still. OK, I won't complain again, but it feels good to vent! I'm actually super glad to be stuck in bed hopefully growing some babies!

Transfer Day!!!

Today was a long awaited day for our family! The morning got crazy getting my son out the door to school, my mister having to run into work, finalizing bed rest preparations, picking up another last minute prescription, and then racing to be at the clinic by 10 am. We checked in, I began drinking my 32 oz. of water to fill my bladder, and then we talked with the embryologist. He had walked by a few times while we were waiting and I was convinced his expression was going to bring us terrible news about only one embryo surviving and that the quality wasn't very good, which would mean our chances of pregnancy were slim. I was totally trembling when we finally talked to him. He reported that two of the six embryos had survived. One looked awesome and one looked pretty good. He recommended and we decided to put both embryos in. He said I should get pregnant and that we have a 50/50 chance of twins. I felt a little stressed that there were not any extra to freeze to help take some pressure off, but then realized I was being greedy and needed to focus on the positive, which has been hard for me since this process failed for us last time. I think my acupuncturist noticed I needed to absorb everything, because she had me pop my Valium (the only medication used for the transfer procedure) and filled me up with acupuncture needles to calm me and my uterus. A "quiet" uterus is important for the embryos. By the time it was time to go to the transfer room I was calm and all cozy wrapped up in a warm blanket. The procedure is only about 15 minutes and using ultrasound the embryos are dropped into the uterus by the reproductive endocrinologist and embryologist. We even watched on the big screen while our babies were drawn up from their lab tubes, filled into the catheter, and then the doctors do a countdown to coordinate placing the embryos and removing the tube. On the ultrasound screen you couldn't see the microscopic embryos but you could see two flashes of light where the medium surrounding the embryos shows up. The worst part of the entire procedure was the full bladder! By this point I'm totally feeling the 32 oz. I drank an hour prior to the procedure, but I have to lay flat another 15 minutes or so. Then, regardless of the fact that I feel like I'm going to leave a mess on the floor, I'm nervous about standing up and disturbing the embryos. My nurse compares the transferred embryos to two grains of sand in a peanut butter sandwich. Repeating that to myself, I shuffled to the bathroom. To be sure my uterus is happy, I had one more acupuncture treatment before going home and getting in bed. Now the waiting begins and it's all up to the embryos to implant into their new home! Here is their first picture:

Final preparations

Today was a busy day! It's a lot of work getting ready to be on bed rest! I had another acupuncture treatment, finalized meal plans, laundry, cleaning, finished up home projects, etc. It's crazy that we won't even know about the embryo(s) until we arrive at the clinic tomorrow! We are very nervous and excited!

Getting closer . . .

Today included a trip to the clinic in the morning to check my hormone levels.  One of them was so high that the lab couldn't even read it!  My nurse said this is a good thing and to continue doing what I'm doing.  Hopefully, all of this will equate to a fluffy and welcoming uterus for our embryo on Tuesday.  I also stayed home from church today as some of my medications compromise my immune system and an illness right now could be detrimental to our transfer.  I'm pretty sure any nasty illness anyone in our home has had, unfortunately came from our loving church family.;)  We need to trick my body into not rejecting the embryo.  Most of my medicines also need to be taken with food and are so frequent that these days leading up to transfer are difficult to go too far from my house for extended periods of time.  Some of the meds also require me to be near a bathroom.  My mom and I "nested" by making 4 loaves of wheat bread, homemade granola, pumpkin cookies, and a yummy dinner.  The fridge and pantry are stocked so we are ready to be confined to the house for a few days after the transfer.

Today we had the option of talking to the embryologist about how our embryos are doing in the lab at this point (3 day old embryos).  We decided not to call.  Day 3 embryos do not necessarily indicate anything about how they'll be on day 5, transfer day.  They can look awful and improve and vice versa.  They are changing through the morula stage today and hopefully getting ready to be strong blastocysts.  We would have only worried and over analyzed each embryos' quality and cell count.  I'm just trying to stay positive and envision happy, dividing embryos in the lab right now.  The embryologist did promise to call today if they had terrible news about our embryos.  There was no call, so we are assuming that is a good sign!

Preparations

In addition to my current medications, heavy hormonal support was begun today in order to prepare my uterus for our upcoming embryo transfer in a few days.  I'm so spacey right now and misplaced my checklist and had to put in an emergency phone call to my nurse early this morning!  My IVF checklist is basically my brain right now and guides me through my daily medicines and appointments.  I carry it around and my life has to revolve around everything on the often changing checklist happening at the exact listed scheduled times.  No worries, my nurse got my up so speed.;)  The additional hormones have me hungry all the time and occasional waves of nausea especially at night if I go more than a few hours without eating.  I don't know how anyone could go through IVF without weight gain!  On a positive note though, my hair and nails are growing like weeds from all of the mega-vitamins!;)    

First Embryo Report

The embryologist called this morning to inform us that all 6 mature embryos fertilized!  We are thrilled with this news, but are still nervous about each of them making it through each day with good cell division.  By day 3 last time, 3 of our 4 embryos had stopped dividing.  Our specific ART (artificial reproductive treatment) is IVF with ICSI (intracytoplasmic sperm injection), and the embryologist mentioned that the ICSI procedure had gone well.  Picking out 6 perfect swimmers from a pool of 40 million is not a job that I would want!  My sister asked if they play romantic music in the lab during this part of the process . . . ha, ha, they probably should!;)  I felt really good today!  My mom, daughter, and I even went out to lunch and shopping for a few hours to celebrate.  I've only had about 12 pills to take today (ha, ha), so other than popping pills in the restaurant, it was an easy day to get away without worrying about a bringing a cooler full of syringes.  Tomorrow more hormones will be added in order to get my uterus prepared for the embryo(s) to be put back in, so the "crazy lady" might pay a visit again.;)  Overall, today was a good day on the IVF roller coaster and that's all I can do is take one day at a time!

Retrieval Day

The retrieval went well today.  I'm a little crampy, but Tylenol is doing the trick.  I also had a nasty wave of nausea earlier in the day, but the anesthesia seems to be making its way out now.  We are still nervous and awaiting our phone call tomorrow morning regarding our fertilized embryo count.  For today, we know that about 12 embryos were retrieved but only about half were mature.  Higher numbers would have been more comforting, but for now we are grateful to have any and hope for just one to make it to the blastocyst stage.  Last time we lost 75% of our embryos on day 3, which was so disappointing.  We're hoping that this batch are better quality embryos that will do well in the lab until it is time to transfer them back home.  It was hard to leave the clinic today, I wanted to stand over them in the lab and tell them they can do it!;)

My favorite moment of the day was a reminder that through all of this I have been in good hands.  After they wheeled me into the surgery room away from my mister, my doctor came in right before I fell asleep.  Despite, the 5 other people (anesthesiologist, nurse, U/S tech, and two embryologists) in the room, he took my hand, and asked how I was doing.  I was freezing, which might partially be a nervous reaction for me, and he quickly grabbed two blankets and tucked me in head to toe.  I so appreciated that and drifted peacefully off to sleep.  The next thing I remember was waking up in recovery and my mister said I was just as chatty as could be and very repetitive.  He does a great imitation.  So funny, because I don't remember talking to anyone!  

The next several weeks are stressful!  It's just a daily waiting game to see which embryos survive and then waiting to see who implants.  Honestly, I think I would prefer a zillion shots a day and getting to this point rather than the constant worry that we now face!  Regardless of how busy and distracted I stay, from today until the first pregnancy test (which should be June 6th) time will stand still.  Hopefully, we will wake up to positive embryo news tomorrow morning, which would be great!

Embryo Retrieval Eve

There's not too much to report today other than I feel yucky!  I'm excited for retrieval tomorrow, but also nervous about the 1,000 things that need to go perfectly in order for things to go well.  The retrieval procedure itself is not bad.  I get an IV, fall asleep, using ultrasound guidance my doctor extracts the mature eggs, and then they wake me up.  I'm sure I won't even recall the drive home, but I will hopefully post an update of our embryo count tomorrow night.  We need lots of prayers and I know miracles happen every day!  Hopefully, we have one tomorrow!

Trigger Time!

Today's ultrasound showed some great growth, so we are ready to go!  I attribute the new growth to an awesome acupuncture treatment we did as a last ditch effort last night.  My estradiol level climbed a little too much, so we have small case of OHSS (ovarian hyper stimulation syndrome) on our hands.  This just means more meds to help counteract that and that my belly is huge!  It hurts to bend or even put on a seatbelt.  My nurse is predicting that we'll retrieve 7-9 embryos and hopefully even have some extra fertilized embryos to biopsy and freeze, which for us is great!  Keeping up with the appointments and med schedules feels like a full time job right now.  Our retrieval is scheduled for 8:30 Thursday, which is exactly 36 hours after my HCG trigger injection.  My nurse used a Sharpie to draw a circle to show my mister where my trigger injection was supposed to go on my bottom, and we got a good laugh when we realized she had drawn a smiley face.  For now, the plan is no more injections!  Hooray!  There are still a lot of meds, but just a little less painful.  I'm so thankful for that because my belly is beyond tender!  So, how many shots did it take to get to retrieval . . . 53!